ONS Connect - August 2008 - (Page 16)

YOUTELLUS How Do You Educate Patients Regarding the Safe Handling of Oral Agents? Education Is Similar to That for IV Chemotherapy e educate our patients on oral chemotherapy medications much the same way as we would for patients getting those medications via IV. We educate them on good hygiene, flushing their toilet twice after use, good hydration, watching for fevers, when to go to the emergency department, skin changes, including nail beds, etc., and include the information on a take-home “do’s and don’ts” sheet. They can post it on their refrigerator for an at-a-glance reference. We have our own oncology pharmacist who also educates on the particular chemotherapy medication patients are on and gives informational handouts. I have been a chemotherapy RN for 11 years and feel we have a great team in our rural area. W farm has a pill window run by nurses, who hand patients their oral agents. We continue to emphasize the need to avoid skin contact because of transdermal absorption and not to break the pill in half or mix it with their other pills to prevent cross contamination. The farm nurses also reiterate this to the patients. Kim D. Littles, RN, BSN, NCIII University of Texas Medical Branch, Texas Department of Criminal Justice Hematology-Oncology 6A Galveston, TX Debra A. Jones, RN, OCN® Manager, Hematology-Oncology and IV Department Summit Regional Medical Center Show Low, AZ Instruction Sheets Provide Easy Reference ur practice locations require that all patients receive an instruction sheet regarding the administration of chemotherapy at home and for traveling while on chemotherapy. The instruction sheets address safety, storage, and handling chemotherapy waste material. O Christine Carlisle, RN, OCN® UPMC Cancer Center Wexford, PA Prison Hospital Has Special Considerations he process used to educate my patients on the safe handling of oral chemotherapy is a little different than most. I work for a prison hospital in Texas, and we are the only facility in the state that can administer chemotherapy agents. Our teaching methods must keep in mind that our patients are also offenders. Once discharged, our patients go home to what is called a “farm.” The T Comprehensive Plan Provides Instruction Sheet and Administration Supplies e have done an extensive quality improvement project in this area. Our staff just received a local Sacramento ONS Chapter Award for the work, and we also have been highlighted by Veterans’ Affairs (VA) as a “best practice.” W After an extensive evidence-based literature review, we developed a comprehensive teaching sheet and plan to manage all patients on oral chemotherapy. Each patient started on oral chemotherapy is given the same nursing risk assessment and teaching that is done for patients receiving IV chemotherapy. We have these forms loaded for charting in our electronic medical records. We also give out a small chemotherapy waste container (worked with environmental staff and logistics to find the appropriate container), gloves, and medicine cups. Patients and/or family members are taught to wash their hands, put gloves on, pour oral chemotherapy pills into the medicine cups, and pour it into patients’ mouths. Then they dispose of the medicine cup and gloves in the chemotherapy waste container. When the container is filled, they seal it and bring it back to a VA site approved for chemotherapy waste. We also track patient and follow-up monitoring with phone calls weekly or as needed by the physician. We are in the process of data gathering for follow-up and developing oral chemotherapy template orders, just like we have for IV chemotherapy, to ensure nothing is missed for this group of patients. Karen Mayo, RN, BSN, CPHQ, OCN® Oncology Clinical Coordinator/ Case Manager VA Medical Center Sacramento, CA 16 ONS CONNECT August 2008

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ONS Connect - August 2008 Contents Editor's Note Just In Safe Handling of Chemotherapy A Year in the Life—Month Eight Put Evidence Into Practice to Manage Dyspnea Web Connect Capitol Connection Notice Nursing Now Caregiver Care KRAS Status Predicts Response to Cetuximab for Metastatic Colorectal Cancer Calendar of Events Working for You Staying on Top

ONS Connect - August 2008

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